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As Bain Capital put it, 2021 was a “banner year” for private equity’s healthcare acquisitions. In addition to hospitals and nursing homes, physician practices have become hot targets. Over the past 10 years, private equity firms have moved on from buying physician staffing companies for hospital-based practices, such as emergency room physicians, anesthesiologists, and radiologists. They are broadening their net to include dermatology, ophthalmology, urology, and orthopedics, women’s health, gastroenterology.
The private equity firm’s main focus is on efficiency, productivity, and short-term profits, not patients. Many physicians left independent practice to seek relief from the administrative aspects of private practice but found they became fungible, income-generating drones in a health care “system.” And patients are paying more and more out of pocket for their care with less choice and, in some cases, lower quality.
A new study looking at 1,400 acquisitions from 2014 to 2019 found that compared to non-acquired dermatology, ophthalmology, and gastroenterology practices, the acquired practices not only replaced more physicians but many were replaced with non-physician clinicians.
For example, Kaiser Health News reported that American Physician Partners, a medical staffing company owned by private equity investors. employs fewer doctors in its ERs as one of its cost-saving initiatives to increase earnings, according to a confidential company document obtained by KHN and NPR. The question arises whether this improves access or decreases quality, or a little of both.
Among many reasons, commitment to science and helping patients heal is why we wanted to be physicians. Sadly, with this new landscape, physicians are becoming less satisfied with the practice of medicine. Nurses, nurse practitioners, and physician assistants are all valuable parts of the health care team. But does this mean they have the requisite skills to practice without physician supervision and are the primary answer to physician shortages?
My guest today is a fierce advocate for patients and physicians. We’ll discuss solutions to the physician shortage and access to quality medical care for everyone.
Nicole “Nikki” M. Johnson, MD, is the past President and a Co-founder of Physicians for Patients, an organization that champions physician-led medical care, seeks to increase the number of practicing physicians, and advocates for transparency of the credentials of health professionals. She received both her undergraduate and medical degrees from Case Western Reserve. Dr. Johnson is certified in both General Pediatrics and Pediatric Critical Care Medicine.
Dr. Johnson is a contributing author of Free 2 Care’s A Physician-Led Roadmap to Patient-Centered Medical Care and advocates for children in the world of Covid through the Urgency of Normal organization. Dr. Johnson engages on Twitter as @notaproviderMD, writing editorials, and publishing blog posts on her substack.
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